Insurance Claims Specialist

Title: Claims Adjuster

Type of Hire: Direct Hire

Work Authorization: US Citizen

Location: Waukesha, WI - 2 days remote, 3 days in the office after initial training period

Job Description

Position Summary

Under the direction of the Claims Manager, the Liability Claims Adjuster will primarily be responsible for general and auto liability claims. The Liability Claims Adjuster is a key business partner managing the investigation, reporting, follow up and settlement of claims. This person performs professional level work requiring the application of legal, medical, and managerial methods to resolve claims. They must be highly organized, detail oriented, and be able to make sound judgment decisions with the ability to maintain timetables/deadlines. They must be able to handle multiple responsibilities, typically requiring quick turnaround. Essential duties and responsibilities are included below. Other duties may be assigned to meet business needs.

Role and Responsibilities

· Investigates multi-line claims of moderate to severe complexity, including claims in litigation

· Conducts claim and incident investigations

· Communicates with claimants to obtain information on claim and provide information on claim process

· Communicates regularly with Safety, Project Managers and Field for claim and incident documentation

· Document and maintain claim files by entering claim/incident data into Risk Management Information System

· Sets timely, adequate reserves in compliance with the organizations reserving philosophy and methodology

· Resolves questions of liability and value of claims

· Secures the necessary official reports, claim forms and documents

· Reviews bills, invoices, and receipts for accuracy

· Identifies opportunities for recovery and investigates and pursues accordingly

· Assists in litigation, mediations, and arbitrations

· Compiles claim reports for Management review to assess liability, claim denial, settlement valuation/authority requests, and/or defense position

· Proven, excellent knowledge of the theory and practice of the claim function

· Analytical ability and sound judgment with respect to liability and coverage

· Knowledge of contract and medical terminology, with minimal legal aspects of court procedures

· Assists with creating claim/safety reports in Origami

· Cross-coverage, worker’s compensation, owned auto and property, when necessary

· Occasionally assists with special projects or assignments with Safety and Legal

Qualifications and Education Requirements

· Bachelor’s degree or equivalent work experience of at least 3 (three) years

· Experience with Risk Management Systems (Stars, Origami) preferred

· Strong proficiency in Microsoft Office

· Ability to multi-task in a fast-paced environment and communicate clearly using various mediums is essential

· Strong communication and interpersonal skills

· Make sound judgment decisions along with the ability to establish and maintain timetables/deadlines while handling multiple demanding projects

· High level of discipline and a strong sense of responsibility and accountability

· Valid driver’s license and considered insurable by insurance standards

Job Type: Full-time

Salary: $70,000.00 - $75,000.00 per year

Schedule:

• 8 hour shift
• Monday to Friday

Work setting:

• In-person

Application Question(s):

• Do you have experience with Claims & Insurance?

Work Location: In person

Salary : $70,000 - $75,000